Weak Pulse (弱脉)

Appearance (体象歌)

弱脉细小，见于沉分；举之则无，按之乃得。

Clinical Indications (主病歌)

弱为阳陷，真气衰弱。左寸心虚，惊悸健忘；右寸肺虚，自汗短气。左关木枯，必苦挛急；右关土寒，水谷之疴。左尺弱形，涸流可征；右尺弱见，阳陷可验。

Clinical Significance

The Weak Pulse indicates decline of yang qi and insufficiency of qi and blood. It is small, thin, and soft in the deep position, absent with light pressure but felt with heavy pressure. It forms when yang qi sinks and fails to propel blood, so that qi and blood cannot fill the superficial vessels. The Weak Pulse is a sign of interior deficiency, especially yang deficiency. At the left inch position, weak pulse indicates heart qi and heart yang deficiency with palpitations, anxiety, and forgetfulness. At the right inch, it reflects lung qi deficiency with spontaneous sweating, shortness of breath, low voice, and susceptibility to external pathogens. At the left guan, it points to liver blood insufficiency with muscle cramps, numbness, and blurred vision. At the right guan, it indicates spleen-stomach deficiency-cold with impaired transformation, presenting as cold abdominal pain, poor appetite, loose stools, and cold limbs. At the left chi, it reflects kidney yin deficiency and essence-blood depletion with weak lower back and knees, seminal emission, tinnitus, and scanty menstruation. At the right chi, it reflects kidney yang decline and sinking yang with cold limbs, impotence, and clear or incontinent urine. The Weak Pulse often reflects constitutional insufficiency or recovery from a severe illness or prolonged stress, and cold intolerance and low energy are common accompanying complaints that guide treatment toward warming supplementation.

Treatment and Care

For yang deficiency with a Weak Pulse, treatment supplements qi, lifts yang, and warms the spleen and kidneys. Heart qi deficiency is treated with Zhi Gan Cao Tang or Sheng Mai San. Lung qi deficiency is treated with Bu Fei Tang or Yu Ping Feng San. Liver blood deficiency is treated with Si Wu Tang or Bu Gan Tang. Spleen-stomach deficiency-cold is treated with Li Zhong Tang or Fu Zi Li Zhong Wan. Kidney yin deficiency is treated with Liu Wei Di Huang Wan or Zuo Gui Wan. Kidney yang decline is treated with Jin Gui Shen Qi Wan, You Gui Wan, or Bu Zhong Yi Qi Tang to lift yang. Daily care emphasizes keeping warm, especially the lower abdomen, lower back, and legs; eating warm foods such as lamb, ginger, longan, Chinese yam, and red dates; and avoiding raw, cold, greasy foods. Avoid overwork, prolonged standing, and walking to prevent yang from sinking further. Moxibustion at Bai Hui, Guan Yuan, Qi Hai, Zu San Li, and Shen Shu lifts yang and secures the root. Foot soaks in warm water before bed can improve circulation and reduce cold sensations in the extremities, and maintaining a regular sleep schedule supports kidney essence and prevents further sinking of yang qi. Gentle exercises such as tai chi and ba duan jin help cultivate primordial qi.